Surgical Research
Open AccessSplenic Abscess in Children: Management at Department of Ignace Deen's General Surgery, University Hospital Center (Chu-Ignace Deen)
Authors: FOFANA Houssein, KEITA Karim, MARA Mariam Thermite, OULARE Ibrahima, SOUMAH Yalikhatou, KOUYATE Kaira, SOUMAORO LT, TOURE Aboubacar.
Abstract
Introduction: Splenic abscess is a less common and serious condition in children, especially when diagnosed late. Nowadays, imaging plays an important role in diagnostic confirmation and therapeutic guidance. Medical and surgical management is complex. The objective was to present two cases of splenic abscess, rarely encountered in our practice at this age.
Clinical Case: It’s about two children, all male, aged 7 and 9, living in a rural area, referred and hospitalized to our department for a splenic abscess. They presented with left subcostal pain accompanied by fever and splenomegaly. They were followed in pediatrics for treatment of malaria, typhoid, and anemia, with no positive results. Upon admission, they presented with a deteriorated general condition, with anorexia, asthenia, and fever. Swelling and firm arching of the left hemiabdomen were observed; this was grade 4 splenomegaly. Ultrasound revealed an enlarged and abscessed spleen. Leukocytosis and anemia were observed. Widal serology was strongly positive, as was the thick smear. Blood glucose and retroviral serology were normal. The patients had no sickle cell disease or abdominal trauma. A midline laparotomy above and below the umbilical nerve revealed a splenic abscess. We performed a total splenectomy. Pus was collected for culture, and the spleens were referred to a pathologist. Antibiotics and analgesics were administered. The patients were discharged with a favorable outcome.
Conclusion: Splenic abscesses are rare; Their causes are numerous and varied, and the initial clinical picture is misleading. Total splenectomy is the most reassuring treatment for late-diagnosed abscesses.
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